﻿<ContinuityOfCareRecord xmlns="urn:astm-org:CCR" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="urn:astm-org:CCR CCR_20051109.xsd">
  <!--
********************************************************
  CCR Header
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-->
  <CCRDocumentObjectID>db734647-fc99-424c-a864-7e3cda82e703</CCRDocumentObjectID>
  <Language>
    <Text>English</Text>
    <Code>
      <Value>en-US</Value>
      <CodingSystem>IETF1766</CodingSystem>
    </Code>
  </Language>
  <Version>V1.0</Version>
  <DateTime>
    <ExactDateTime>2000-04-07T13:00:00+0500</ExactDateTime>
  </DateTime>
  <Patient>
    <ActorID>2-16-840-1-113883-19-5-996756495</ActorID>
  </Patient>
  <From>
    <ActorLink>
      <ActorID>8a54f393-8015-460c-abd2-f29aad15481c</ActorID>
      <ActorRole>
        <Text>author</Text>
      </ActorRole>
    </ActorLink>
  </From>
  <Purpose>
    <Description>
      <Text>Transfer of care</Text>
      <Code>
        <Value>308292007</Value>
        <CodingSystem>SNOMED CT</CodingSystem>
      </Code>
    </Description>
  </Purpose>
  <Body>
  </Body>
  <Actors>
    <Actor>
      <ActorObjectID>2-16-840-1-113883-19-5-996756495</ActorObjectID>
      <Person>
        <Name>
          <CurrentName>
            <Given>Henry</Given>
            <Family>Jones</Family>
            <Suffix>the 7th</Suffix>
          </CurrentName>
        </Name>
        <DateOfBirth>
          <ExactDateTime>1932-09-24</ExactDateTime>
        </DateOfBirth>
        <Gender>
          <Text>Male</Text>
          <Code>
            <Value>M</Value>
            <CodingSystem>2.16.840.1.113883.5.1</CodingSystem>
          </Code>
        </Gender>
      </Person>
      <IDs>
        <Type>
          <Text>Patient ID</Text>
        </Type>
        <ID>2-16-840-1-113883-19-5-996756495</ID>
        <IssuedBy>
          <ActorID>2.16.840.1.113883.19.5</ActorID>
        </IssuedBy>
        <Source>
          <Actor>
            <ActorID>8a54f393-8015-460c-abd2-f29aad15481c</ActorID>
          </Actor>
        </Source>
      </IDs>
      <IDs>
        <Type>
          <Text>Covered party ID</Text>
        </Type>
        <ID>14d4a520-7aae-11db-9fe1-0800200c9a66</ID>
        <IssuedBy>
          <ActorID>329fcdf0-7ab3-11db-9fe1-0800200c9a66</ActorID>
        </IssuedBy>
        <Source>
          <Actor>
            <ActorID>8a54f393-8015-460c-abd2-f29aad15481c</ActorID>
          </Actor>
        </Source>
      </IDs>
      <Source>
        <Actor>
          <ActorID>8a54f393-8015-460c-abd2-f29aad15481c</ActorID>
        </Actor>
      </Source>
    </Actor>
  </Actors>
</ContinuityOfCareRecord>
